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APPLICATION FORM FOR AVAILING ASSISTANCE ON POWER TILLER/ TRACTOR.

To
The Deputy Director of Agriculture
____________________________

Subject: - Proposal for availing assistance on power tillers/tractors under Centrally Sponsored
Macro Management Scheme.

Sir,
I ____________________________S/o ____________________intends to avail assistance on power
tiller/ tractor under Centrally Sponsored Macro Management scheme on my land at Village
_____________P.O. _____________Tehsil _________________District _____________. The proposal/ cost
estimate obtained from the Manufacturer authorised dealer is also attached.

1. Location and address of the farmer.


2. Land holding owned by the beneficiary (proof of land ownership by attached through Kisan Pass book
or certificate of Patwari.
3. Type of land irrigated/ un-irrigated.
4. Crops grown.
5. Total cost estimate of the power tiller/ tractor Rupees________________
6. Name of manufacturer, Model, H.P.

i) I/We certify that the particulars furnished above by me/ us are true to the best of my /our knowledge
and belief that nothing has been concealed therein.
ii) I/ We give an undertaking to the effect that the Department of Agriculture and other concerned agencies
shall have the right to inspect the machine.
iii) In case of the mis-utilization or non-utilization of assistance, I/ We undertake to refund the amount of
assistance granted to me/ us in full and in lump sum along with the interest at the prevailing Bank rates
thereon.
iv) I certify that no assistance/ subsidy has been availed by me on the power tiller/ tractor earlier.
Yours faithfully

Name & address of the applicant.

Application along with project proposal/ relevant documents (revenue papers of land, proforma
invoice) for assistance to the extent of Rs.__________, is forwarded to the SMS Development Block
_____________Distt. _____________,H.P. for consideration and onward transmission to the Deputy Director
of Agriculture ______________.

Agriculture Development Officer


Dev. Block/ Circle___________
Distt. ______________H.P.

Countersigned/ recommendations to the Deputy Director of Agriculture ______________________

Subject Matter Specialist


Dev. Block _______________